Nurse to bed ratio and nutrition support in critically ill patients

• Published in: American journal of critical care Vol. 22; no. 6; pp. e71 - e78
• Main Authors: Honda, Carolina Keiko Yamamoto, Freitas, Flávio Geraldo Rezende, Stanich, Patricia, Mazza, Bruno Franco, Castro, Isac, Nascente, Ana Paula Metran, Bafi, Antonio Toneti, Azevedo, Luciano Cesar Pontes, Machado, Flávia Ribeiro
• Format: Journal Article
• Language: English
• Published: United States 01.11.2013
• Subjects: Aged; Analgesics, Opioid - adverse effects; Analgesics, Opioid - therapeutic use; APACHE; Comorbidity; Critical Illness - nursing; Critical Illness - therapy; Energy Intake; Enteral Nutrition - methods; Enteral Nutrition - standards; Enteral Nutrition - statistics & numerical data; Female; Fentanyl - adverse effects; Fentanyl - therapeutic use; Humans; Hypnotics and Sedatives - adverse effects; Hypnotics and Sedatives - therapeutic use; Intensive Care Units - manpower; Intensive Care Units - standards; Intensive Care Units - statistics & numerical data; Logistic Models; Male; Midazolam - adverse effects; Midazolam - therapeutic use; Middle Aged; Nursing; Nursing Staff, Hospital - standards; Nursing Staff, Hospital - supply & distribution; Nutritional Support - methods; Nutritional Support - standards; Nutritional Support - statistics & numerical data; Phenylpropanolamine - adverse effects; Phenylpropanolamine - therapeutic use; Prospective Studies; Sympathomimetics - adverse effects; Sympathomimetics - therapeutic use; Tramadol - adverse effects; Tramadol - therapeutic use; Workload - standards; Workload - statistics & numerical data; Brazil
• ISSN: 1062-3264; 1937-710X
• DOI: 10.4037/ajcc2013610

Inadequate nutrition support is common among critically ill patients, and identification of risk factors for such inadequacy might help in improving nutrition support. To determine how often daily calorie goals are met and the factors responsible for inadequate nutrition support. Methods A single-center prospective cohort study. Each patient's demographic and clinical characteristics, the need for ventilatory support, the use and dosage of medications, the number of nursing staff per bed, the time elapsed from admission to the intensive care unit until the effective start of enteral feeding, and the causes for nonadministration were recorded. Achievement of daily calorie goals was determined and correlated with risk factors. A total of 262 daily evaluations were done in 40 patients. Daily calorie goal was achieved in only 46.2% of the evaluations (n = 121), with a mean of 74.8% of the prescribed volume of enteral nutrition infused daily. Risk factors for inadequate nutrition support were the use of midazolam (odds ratio, 1.58; 95% CI, 1.18-2.11) and fewer nursing professionals per bed (odds ratio, 2.56; 95% CI, 1.43-4.57). Conclusion Achievement of daily calorie goals was inadequate, and the main factors associated with this failure were the use and dosage of midazolam and the number of nurses available.